| NPI | 1982606919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS002886L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS002886L) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA OS002886L) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2016-01-27 |