| NPI | 1942317482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD442416) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 45781) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036102902) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2011-07-12 |