| NPI | 1639330012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NJ 25MA08769100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08769100) |
| 207R00000X Internal Medicine (Licence: NY 257964) | |
| 207RI0008X Internal Medicine Hepatology (Licence: NJ 25MA08769100) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2020-01-16 |