| NPI | 1588862619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 30031) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL30031) |
| 207R00000X Internal Medicine (Licence: SC 30031) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 066388) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2015-02-03 |