| NPI | 1295743656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: WI 35541-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 32665) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: KY 32665) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2021-01-28 |