| NPI | 1972568251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: WV 21002) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 21002) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2010-01-21 |