| NPI | 1023471695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 1027726) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 314594) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2026-07-23 |