| NPI | 1144314014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 45530) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD040068E) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-04-27 |