| NPI | 1104810209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 16972) |
| Additional Taxonomies | 174400000X Specialist (Licence: NE 16972) |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2018-02-19 |