| NPI | 1164678637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01069315A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT190070) |
| 207R00000X Internal Medicine (Licence: CO DR.0052429) | |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2014-08-04 |