| NPI | 1184666547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A38525) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: CA A38525) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2016-09-15 |