| NPI | 1265427504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NM MD2015-0106) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101237677) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2020-09-15 |