| NPI | 1659484566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA a49849) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA a49849) |
| 207R00000X Internal Medicine (Licence: CA a49849) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2009-03-18 |