| NPI | 1295936920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME 106752) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 7856) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 244643) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2010-09-10 |