| NPI | 1821289141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 61054) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.052595) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2013-08-09 |