NPI | 1639599673 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 290254) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-04-17 |
Last Update Date | 2022-02-24 |