| NPI | 1972599389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL OS0004502) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS0004502) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2016-11-15 |