| NPI | 1134200025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN MD008559) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 05332) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2007-07-08 |