| NPI | 1942659529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 0445850) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2022008557) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301109278) | |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2022-06-09 |