| NPI | 1750766655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD227695) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD492247) |
| 207R00000X Internal Medicine (Licence: PA MD492247) | |
| 207R00000X Internal Medicine (Licence: NY xxx) | |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2026-07-15 |