NPI | 1669931432 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301514012) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD481430) |
207R00000X Internal Medicine (Licence: PA MD481430) | |
Enumeration Date | 2019-03-19 |
Last Update Date | 2025-06-24 |