| NPI | 1851374151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD34011) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0059728) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2015-06-25 |