| NPI | 1902080278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CT 047545) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 047545) |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2014-01-14 |