| NPI | 1609848696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD032268E) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 179149-1) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2021-03-29 |