| NPI | 1104189182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 294141) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT201950) |
| Enumeration Date | 2012-06-24 |
| Last Update Date | 2018-06-27 |