NPI | 1003196353 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2013-00102) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 60258255) |
Enumeration Date | 2011-08-18 |
Last Update Date | 2022-07-21 |