| NPI | 1013229996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD184561) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 60303) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2021-06-04 |