| NPI | 1215902184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME98495) |
| Additional Taxonomies | 174400000X Specialist (Licence: NM 2001-318) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2012-07-31 |