| NPI | 1861430795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD469765) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 20650) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 259078) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2024-06-05 |