| NPI | 1275571945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: PA MD 055985-L) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NJ MA 064781) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2014-10-02 |