| NPI | 1912911686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA C53974) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY FL010) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: KY FL010) | |
| 207R00000X Internal Medicine (Licence: CA C53974) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2015-07-20 |