| NPI | 1154322089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 200300064) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NC 200300064) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2022-10-13 |