| NPI | 1982101069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 1019373) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 12236683-1205) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2024-06-12 |