| NPI | 1932333440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: PA MD461663) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: VA 0101247916) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2023-03-07 |