| NPI | 1881816619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 21994) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116018498) |
| 207R00000X Internal Medicine (Licence: KY 42701) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2012-08-06 |