| NPI | 1104888544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD436400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD436400) |
| 207R00000X Internal Medicine (Licence: IN 01057964A) | |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2021-12-03 |