| NPI | 1003895632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL MFC1616) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 32557) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2009-06-26 |