| NPI | 1952301277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60347981) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA05287300) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2013-07-08 |