| NPI | 1619972783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: SD 3798) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: CA G88404) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2014-10-28 |