| NPI | 1619395795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MA 260891) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: ZZ 395805) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2014-10-21 |