| NPI | 1992759005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: RI MD06550) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 026027) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2012-11-16 |