| NPI | 1285633552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: LA MD-015604) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: OK 24166) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: NY 26706) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2021-08-03 |