| NPI | 1922155720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD.201576) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 64956) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2012-08-10 |