| NPI | 1063807261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME154113) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10052374) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2022-07-07 |