| NPI | 1962622431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: SD 8388) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: IA 4307) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: NE 933) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2014-10-07 |