| NPI | 1730116252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 34379) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MA 34379) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2011-06-15 |