| NPI | 1376864157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME126794) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10037738) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2016-08-10 |