| NPI | 1528186384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA09117700) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301085780) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301085780) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2019-08-14 |