| NPI | 1689658882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OK 11864) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G43065) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2011-08-10 |