| NPI | 1366476541 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 11979) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 23533) | 
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME55806) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 021892) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 05215R) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX F9045) | |
| Enumeration Date | 2006-07-11 | 
| Last Update Date | 2012-03-30 |