| NPI | 1215487509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD459693) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 98-01686) |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2021-06-29 |