| NPI | 1467641423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME122708) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD438399) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA09078200) | |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2021-09-14 |