| NPI | 1497757256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 9600367) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: NC 9600367) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2018-08-06 |