| NPI | 1922414226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD473038) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA FB0141642) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2021-06-02 |