| NPI | 1073710992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME105816) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL MD 30868) |
| 207R00000X Internal Medicine (Licence: FL ME 105816) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2014-08-27 |