| NPI | 1417146846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 21412) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO 21412) |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2016-02-18 |