| NPI | 1114999612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 10089722-1205) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD422706) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2021-10-21 |