| NPI | 1295706687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD488874C) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101233646) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 75301) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2025-09-15 |