| NPI | 1114903994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD050640L) |
| Additional Taxonomies | 207RI0008X Internal Medicine, Hepatology (Licence: PA MD050640L) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2015-11-12 |