| NPI | 1861690471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME 018451) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD430574) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD430574) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2011-02-07 |