| NPI | 1386742484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME38419) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 21375) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-05-01 |