| NPI | 1316332984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 296003) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2026-01032) | |
| 207R00000X Internal Medicine (Licence: NY 296003) | |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2026-05-06 |