| NPI | 1407898240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 54172) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 028964) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2010-02-24 |