| NPI | 1922369248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036145137) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 291761) |
| 207R00000X Internal Medicine (Licence: NM MD2015-0458) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2018-07-02 |