| NPI | 1982018156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY E000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY E000) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2021-03-22 |