| NPI | 1982652814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MA 223517) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 223517) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2015-03-30 |