| NPI | 1740800135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA11907200) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: NJ 25MA11907200) | |
| Enumeration Date | 2020-04-26 |
| Last Update Date | 2026-07-09 |