| NPI | 1538257464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MA 230438) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NH 14969) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2015-01-21 |