| NPI | 1457328486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2012009726) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME95014) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME95014) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2012-08-10 |