| NPI | 1285679456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NM MD2014-0875) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MT 12784) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2015-09-30 |