| NPI | 1720494347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 73260) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60739117) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2024-07-22 |