| NPI | 1093018285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036.126831) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036126831) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116023346) | |
| Enumeration Date | 2010-12-10 |
| Last Update Date | 2020-07-20 |