| NPI | 1588049282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MT209365) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA11003700) |
| 207R00000X Internal Medicine (Licence: PA MD470023) | |
| 207R00000X Internal Medicine (Licence: PA mt009365) | |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2024-05-07 |