| NPI | 1952720807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 86108) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MB10442900) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: NJ 25MB10442900) | |
| 207R00000X Internal Medicine (Licence: GA 86108) | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2022-06-28 |