| NPI | 1922628304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 34504) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 34504) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-25 |
| Last Update Date | 2025-05-13 |