| NPI | 1417158536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD 202307) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 202307) |
| 207R00000X Internal Medicine (Licence: LA MD.202307) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2014-11-07 |