| NPI | 1063825131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 66534) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-259656) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2020-09-06 |