| NPI | 1063675049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301091687) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301091687) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2015-07-14 |