| NPI | 1003895749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2010003215) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-114186) |
| 207R00000X Internal Medicine (Licence: WI 50318-020) | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2011-02-03 |