| NPI | 1699774869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX G8150) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX G8150) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2012-04-16 |