| NPI | 1376898338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA12404800) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 316524) | |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2024-09-04 |