| NPI | 1063460624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA OS005356L) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MB05264300) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-05-04 |