| NPI | 1518956085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME37121) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0037121) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2009-12-07 |