| NPI | 1568805836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MT212577) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2016-0634) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2021-03-29 |