| NPI | 1861619058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME 017628) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: RI LP00462) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2008-08-25 |