| NPI | 1689663700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 96-00445) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 9600445) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2017-01-23 |