| NPI | 1043472731 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 56362)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 56362-20)  | 
| Enumeration Date | 2008-06-25 | 
| Last Update Date | 2014-07-07 |