| NPI | 1639111628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G15034) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 2759R) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2007-07-08 |