| NPI | 1104911627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD451521) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH RT-1560) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 14352) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2014-08-21 |