| NPI | 1639163587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 17747) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 17747) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2007-07-08 |