| NPI | 1871090688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX T1496) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: TX T1496) | |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2025-12-08 |