| NPI | 1508359381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MT230721) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 31548) |
| 207R00000X Internal Medicine (Licence: PA MD484562) | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2024-06-30 |