| NPI | 1578758124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 15674) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT189084) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD445519) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2015-02-10 |