| NPI | 1316208473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 278591) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 59072) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2019-05-31 |