| NPI | 1184763112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CA A88044) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NM 2005-0431) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-05-27 |