| NPI | 1972561843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 74396) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 74396) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2011-02-11 |