| NPI | 1104916170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 022323) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 022323) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-09 |