| NPI | 1821296039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME105673) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL TRN11397) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2010-10-12 |