| NPI | 1164496733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD020642E) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 143022-1) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2011-06-22 |