| NPI | 1699702647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2008017825) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2008017825) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2016-04-23 |