| NPI | 1346697273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 31602) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 31602) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2023-05-15 |