| NPI | 1386678225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2015-01248) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL 00024244) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2016-08-16 |