| NPI | 1568606036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A121936) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT194795) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT194795) | |
| 207R00000X Internal Medicine (Licence: PA MD444485) | |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2017-04-26 |