| NPI | 1720062011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME 4394) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 073618) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2015-05-06 |