| NPI | 1174837421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD447081) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: FL Trn19073) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2022-07-21 |