| NPI | 1467403881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101243529) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 45285) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2008-08-06 |