| NPI | 1154640225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2016012330) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-8906) |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2020-01-14 |