| NPI | 1124258777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2015021892) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL DO.1164) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2015-11-02 |