| NPI | 1356622799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 40689) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 40689) |
| 207R00000X Internal Medicine (Licence: WV 2735) | |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2020-12-08 |