| NPI | 1508874850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 46937) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 15291) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2011-09-07 |