| NPI | 1114926250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NC 21429) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 21429) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 21429) | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2021-04-22 |