| NPI | 1285696161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 107458) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 31007) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2014-05-06 |