| NPI | 1821040155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0102049900) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 519) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2011-03-04 |