| NPI | 1588643910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-133338) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD016347E) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036-133338) | |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2014-02-18 |