| NPI | 1205855715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MO 31589) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 31589) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2011-04-04 |