| NPI | 1972761534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 71413) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 003104) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2014-07-01 |