| NPI | 1811379324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD472383) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 7498) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2022-05-11 |