| NPI | 1902223894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 33992) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 9560109-1205) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2022-02-11 |