| NPI | 1588649743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VT 042.0012837) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 60366) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2014-07-25 |