| NPI | 1447461116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 65534) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 19896) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N2043) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2017-10-17 |