| NPI | 1730179813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD429940) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 207642) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 207642) | |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2012-10-03 |