| NPI | 1114906195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME107451) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 22982) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX M3548) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2011-05-23 |