| NPI | 1699751248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 32831) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 32831) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2007-11-09 |