| NPI | 1639171481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 015401) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 026122) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2010-08-16 |