| NPI | 1467427120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MD D0070391) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD422861) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2010-06-28 |