| NPI | 1003906017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 25131) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME 18456) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-10-06 |