| NPI | 1083691356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101259433) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: HI MD-14256) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2016-06-15 |