| NPI | 1649203761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: LA 025602) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MS 20193) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2013-11-14 |