| NPI | 1740574870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101267806) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MD16939) |
| 208D00000X General Practice (Licence: HI MD16939) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2023-10-25 |