| NPI | 1013355528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2016-00758) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2016-00758) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 65035) | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2021-06-25 |