| NPI | 1487651519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 15169) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA 21661) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2012-07-03 |