| NPI | 1265495139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G68568) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G68568) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2014-03-10 |