| NPI | 1396748711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 25760) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 39536) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2015-11-30 |