| NPI | 1760559371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 48642) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036-105804) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2007-07-08 |