| NPI | 1457420861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CA G7094) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G7094) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2008-01-16 |