| NPI | 1700968880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 50499 020) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 35649) |
| 207R00000X Internal Medicine (Licence: WI 50499) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2010-12-29 |