| NPI | 1073524591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 11701R) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 11701R) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2017-01-09 |