| NPI | 1669443909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: ID M-12760) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101239001) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: ND 12112) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2015-07-09 |