| NPI | 1871692319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 14750) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 14750) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2016-12-15 |