| NPI | 1205058856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A109110) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA mt048452t) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2015-12-30 |