| NPI | 1275878787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME153258) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0102518) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: MD D0102518) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD452678) | |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2026-05-10 |