| NPI | 1326131863 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD11288)  | 
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD11288)  | 
| 207R00000X Internal Medicine (Licence: OR MD11288)  | |
| Enumeration Date | 2006-10-02 | 
| Last Update Date | 2013-04-11 |