| NPI | 1376537563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 027807) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 135415) |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2008-01-09 |