| NPI | 1730208562 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01072095A) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301087889) | 
| Enumeration Date | 2007-03-29 | 
| Last Update Date | 2025-03-16 |