| NPI | 1316917214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 200400530) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: PA MD439742) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: SC 28554) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2023-03-07 |