| NPI | 1710372321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 310655) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 310655) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036.146160) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2022-12-31 |