| NPI | 1619906963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G22752) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA G22752) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G22752) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2014-08-20 |