| NPI | 1255640058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 62055) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125053956) |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2023-10-13 |