| NPI | 1538243720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AR E5204) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 37470) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2014-02-24 |