| NPI | 1114193612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 262160) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 49635) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2016-01-05 |