| NPI | 1063555894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME101758) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OK 22400) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2012-09-19 |