| NPI | 1053486126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 65917) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL27172) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2015-03-10 |