| NPI | 1538159546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: PA MD020689E) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: OR MD195987) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2023-01-13 |