| NPI | 1881127140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR0074429) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 5101025985) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: CO DR0074429) | |
| 207R00000X Internal Medicine (Licence: MI 5101025985) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2026-03-02 |