| NPI | 1295381820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036159511) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.074500) |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2025-04-05 |