| NPI | 1265725758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MS 24910) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 207R00000X) |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2020-11-16 |