| NPI | 1558304014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: PA MD426274) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD426274) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2015-06-16 |