| NPI | 1952390213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: RI 6651) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MA 54807) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2010-09-27 |