| NPI | 1407894579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301028211) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301028211) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2022-03-01 |