| NPI | 1952495756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MT 7982) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: WY 4385A) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: WI 26812) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2009-03-03 |