| NPI | 1710078027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD040368E) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 47447-020) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2007-07-08 |