| NPI | 1164551990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 53284) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD428572) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD428572) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD00047781) | |
| 207R00000X Internal Medicine (Licence: WA MD00047781) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2011-08-25 |