| NPI | 1053544130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2012009840) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME123754) |
| 207R00000X Internal Medicine (Licence: PA MT195392) | |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2020-09-21 |