| NPI | 1992325104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR0071714) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO TL.0008372) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0008372) | |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2024-01-31 |