| NPI | 1710905823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD070996L) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME MD 19494) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2014-04-04 |