| NPI | 1063678738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2008013979) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA OS017342) |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2014-11-19 |