| NPI | 1801151907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD481166) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 29194) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2024-07-26 |