| NPI | 1770558959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 12948) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA 24652) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2009-12-31 |