| NPI | 1720076607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2004008628) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2004008628) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2013-07-22 |