| NPI | 1306253349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036168575) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA MD-47761) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2014016485) | |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2025-05-14 |