| NPI | 1154301679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD430225) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA05167000) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ MA05167000) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2014-03-12 |