| NPI | 1326005364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 15922) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 15922) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2013-12-12 |