| NPI | 1821485962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0063646) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 391250) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2021-09-23 |