| NPI | 1063705135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: GA 79573) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101019313) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2021-01-21 |