| NPI | 1306957527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101259170) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036-053364) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD431386) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.096129) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-01-08 |