| NPI | 1174525117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD03476SE) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD03476SE) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2015-09-18 |