| NPI | 1881005395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NJ 25MA11585200) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 290592) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2023-06-27 |