| NPI | 1770786378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD182568) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD444829) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MT195034) | |
| Enumeration Date | 2007-06-09 |
| Last Update Date | 2017-06-06 |