| NPI | 1104094739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D69337) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MT185907) |
| Enumeration Date | 2008-02-17 |
| Last Update Date | 2013-02-11 |