| NPI | 1346723616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MT236672) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.080399) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2026-05-20 |