| NPI | 1578866885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA g061465) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA G061465) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G061465) | |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2010-12-08 |