| NPI | 1902813967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: PA MD463138) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM 2002-0066) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: NM 2002-0066) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2018-04-19 |