| NPI | 1578775854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 32534) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 27120) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2011-05-23 |