| NPI | 1871787663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60430435) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH none) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MT196537) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD041204) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD441342) | |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2014-07-30 |