| NPI | 1700874179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0059594) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: DE C10006596) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2018-08-22 |