| NPI | 1689661860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AL DO140) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA OS004860L) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2007-07-09 |