| NPI | 1982882874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: LA MD.204394) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2008-00905) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: NC 2008-00905) | |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2011-11-02 |