| NPI | 1417064825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 29890) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD459392) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IA 35547) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2026-03-05 |