| NPI | 1700865607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD465345) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD040303E) |
| 174400000X Specialist (Licence: NJ 25MA06206300) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2019-01-14 |