| NPI | 1821472663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0116031514) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10053432) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 285960) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2021-10-14 |