| NPI | 1346272549 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL me0062021) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD191900) | 
| Enumeration Date | 2006-07-07 | 
| Last Update Date | 2019-03-18 |