| NPI | 1609068428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 271211-01) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2022-09-28 |