| NPI | 1043420722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ND 11489) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R7350) |
| 207R00000X Internal Medicine (Licence: IA 37200) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2022-03-25 |