| NPI | 1023384120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 76711) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 64471) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 274949) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 39020000X) | |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2024-03-19 |