| NPI | 1689719346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL me18318) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME18318) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL me18318) | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2010-01-20 |