| NPI | 1356509947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 295203) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2021-02901) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301105873) | |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2022-12-13 |