| NPI | 1760821748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 301747) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.022398) |
| 207R00000X Internal Medicine (Licence: OH 35.126961) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-23 |
| Last Update Date | 2024-02-14 |