| NPI | 1609877521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD055089L) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 25684) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2021-08-23 |