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 |