| NPI | 1942292040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 27767) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 10779) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2011-02-02 |