| NPI | 1609851591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G85405) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 101231578) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2007-08-28 |