| NPI | 1275556920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: SD 7902) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD012134E) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2011-03-16 |