| NPI | 1780657544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD047704L) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD47704L) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2023-03-08 |