| NPI | 1053387613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 171866-1) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD040004E) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2011-07-29 |