| NPI | 1861479594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD489596) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 59979) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 59979) | |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2025-07-15 |