| NPI | 1780662320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 36171) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 36171) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2009-11-20 |