| NPI | 1184905572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A165942) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD452281) |
| 208M00000X Hospitalist (Licence: PA MD452281) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2020-07-14 |