| NPI | 1265477046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0043148) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 43148) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2016-08-08 |