| NPI | 1053362723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME67895) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: TN 26687) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2011-05-24 |