| NPI | 1700817269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: RI 12041) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 210642) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2012-03-21 |