| NPI | 1912124256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD438507) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT186406) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2021-10-26 |