| NPI | 1720605223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 9547) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT220532) |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2023-07-27 |