| NPI | 1427190461 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD445902) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P19880) | 
| Enumeration Date | 2007-02-13 | 
| Last Update Date | 2013-11-21 |