| NPI | 1164500500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD448203) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 28999) |
| 207R00000X Internal Medicine (Licence: SC LL28999) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2020-08-17 |