| NPI | 1275639361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 5101007200) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 1233) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2010-06-21 |