| NPI | 1861888240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 69214) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 66408-20) |
| 207R00000X Internal Medicine (Licence: PA MT216096) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2023-11-16 |