| NPI | 1851359731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL 53017) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 45365) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2016-11-17 |