| NPI | 1780061911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: WA OP61113295) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.012566) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R2997) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2021-07-03 |