| NPI | 1053671982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 71167) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO3052) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2021-03-26 |