| NPI | 1306036447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME148176) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 54673) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2020-12-24 |