| NPI | 1134311236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A97611) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A97611) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2014-08-22 |