| NPI | 1902099484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD154326) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME101345) |
| 207R00000X Internal Medicine (Licence: PA MT186045) | |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2024-11-18 |