| NPI | 1114119187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 50708) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: RI MD12650) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2016-04-04 |