| NPI | 1104034230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 89714) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2004-01577) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2023-06-12 |