| NPI | 1023295300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: ND 16013) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08520900) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: MI 4301100644) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: NJ 25MA08520900) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2020-10-02 |