| NPI | 1821093592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2008-00082) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 037512) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2014-12-10 |