| NPI | 1912117912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036-120237) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 45630) |
| 208M00000X Hospitalist (Licence: IL 036.120237) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2024-07-19 |