| NPI | 1922070416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD034867L) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: PA MD034867L) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2009-09-09 |