| NPI | 1639104151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G16494) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G16494) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2012-01-19 |