| NPI | 1376549816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 17272) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 05144R) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2014-04-09 |