| NPI | 1457798506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 278384) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 56817) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 56817) | |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2020-10-06 |