| NPI | 1376679761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MA 238133) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 229062) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2015-05-12 |