| NPI | 1871571802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A069667) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: CA A069667) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2018-05-10 |