| NPI | 1164646642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A92433) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 48281) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2014-01-28 |