| NPI | 1104870971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AL 12752) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 077288) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2017-01-13 |