| NPI | 1760443139 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD463057) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25ma07068500) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2018-01-29 |