| NPI | 1326001140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101031959) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 22857) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2010-03-02 |