| NPI | 1457430886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G56656) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA FT574Z) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA FT574Z) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G56656) | |
| 207R00000X Internal Medicine (Licence: CA FT562A) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA FT562A) | |
| Enumeration Date | 2006-11-05 |
| Last Update Date | 2012-03-14 |