| NPI | 1417214214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 55026) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 055026) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OK 6151) | |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2022-07-21 |