| NPI | 1548475031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: SD 7963) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.008546) |
| 207R00000X Internal Medicine (Licence: SD 7963) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2011-07-08 |