| NPI | 1104888254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D13526) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 59992) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2020-06-24 |