| NPI | 1720025463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 23706) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA 37209) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2009-12-07 |