| NPI | 1003823683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CT 050624) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 239729) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2012-06-01 |