| NPI | 1235346685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CO 50305) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MO 2010004029) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2013-06-11 |