| NPI | 1750739009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101265214) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116029011) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0105810) | |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2026-05-19 |