| NPI | 1861579450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 26187) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL27138) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2011-07-07 |