| NPI | 1225052319 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD.208249) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A062387) | 
| Enumeration Date | 2006-07-26 | 
| Last Update Date | 2015-12-15 |