| NPI | 1881908119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MA 277080) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: CA A140888) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2023-08-11 |