| NPI | 1821241845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: UT 7152060-1205) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: UT 7152060-1205) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2022-01-28 |