| NPI | 1366539991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD201763) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 225133) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2009-11-23 |