| NPI | 1255396404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD5580) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0017935) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD5580) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0017935) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2007-07-08 |