| NPI | 1750624532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 288928) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 288928) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-31 |
| Last Update Date | 2024-08-21 |