| NPI | 1942255682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 55808) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MT 6420) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2016-08-10 |