| NPI | 1477872158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101262381) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT197046) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT197046) | |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2022-07-21 |