| NPI | 1639145683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MA 124423) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 203918) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2014-04-23 |