| NPI | 1376770115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 252384) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA C161160) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2020-09-23 |