| NPI | 1619071230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 024826) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 024826) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2011-04-29 |