| NPI | 1568413011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TX D8539) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX D8539) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2007-07-08 |