| NPI | 1629170246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0025910) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0025910) |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2012-03-09 |