| NPI | 1710005970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35098773) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA-85003) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ MA-85003) | |
| 207R00000X Internal Medicine (Licence: PA MD440935) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2022-11-03 |