| NPI | 1033129390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WY 10468A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 18203) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2022-09-28 |