| NPI | 1891991717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 42979) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ 76499) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2025-01-02 |