| NPI | 1366858011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101272714) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 59781) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A147577) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2021-08-23 |