| NPI | 1124005442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: GA 058553) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 45081) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2014-08-28 |