| NPI | 1770232357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0008X Internal Medicine, Hepatology (Licence: PA MD495299) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2026-05-01 |