| NPI | 1164089777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: RI LP05518) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 279943) |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2022-07-01 |