| NPI | 1306133988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL 153144) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 289888) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2022-02-21 |