| NPI | 1194722454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME 011068) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 5353) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2009-02-02 |