| NPI | 1447256540 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME76396) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME76396) | 
| Enumeration Date | 2005-06-23 | 
| Last Update Date | 2010-06-18 |