| NPI | 1487686242 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME 017819)  | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101238351)  | 
| Enumeration Date | 2006-07-06 | 
| Last Update Date | 2009-09-17 |