| NPI | 1134566268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 255763) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 306418) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2021-05-26 |