| NPI | 1386879401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 254957) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT195299) |
| 207R00000X Internal Medicine (Licence: PA MT195299) | |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2019-02-19 |