| NPI | 1538502596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: PA MD479001) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 2020-02457) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2022-09-01 |