| NPI | 1720344849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA OS018470) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS018470) |
| 208M00000X Hospitalist (Licence: PA OS018470) | |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2018-06-12 |