| NPI | 1336473172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MA 271088) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 539152) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: TX Q4597) | |
| Enumeration Date | 2009-09-27 |
| Last Update Date | 2022-07-21 |