| NPI | 1376528844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MO R4C31) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R4C31) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2014-01-14 |