| NPI | 1417253428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 89825) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 60325) |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2023-11-08 |