| NPI | 1023125291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101243737) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301075875) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2008-07-10 |