| NPI | 1245590264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 2016-00550) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT201715) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2020-08-11 |