| NPI | 1083645477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2015-00288) |
| Additional Taxonomies | 174400000X Specialist (Licence: DE C1-0007922) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2021-04-13 |