| NPI | 1649657701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: PA OS018548) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: PA OT016294) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2022-04-26 |