NPI | 1962429803 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD-034364-L) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101023699) |
Enumeration Date | 2006-07-16 |
Last Update Date | 2007-07-08 |