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 |