| NPI | 1194039347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME137089) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 003680) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 265927) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 265927) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2019-03-04 |