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 |