| NPI | 1619064094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 55101) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 57588201205) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2015-12-30 |