| NPI | 1720039084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO R1G33) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 0421559) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2012-10-16 |