| NPI | 1891755856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301088974) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD425253) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2020-10-23 |