| NPI | 1609003912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 075734) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL31797) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 31797) | |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2016-09-19 |