| NPI | 1275510257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0014609) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D14609) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2007-10-23 |