| NPI | 1184654634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME0077832) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME0077832) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2012-10-10 |