| NPI | 1821020066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ND 4002) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 23785) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2012-05-07 |