| NPI | 1821520784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 33594) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 33594) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2024-07-25 |