| NPI | 1417292392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL OS14335) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS14335) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 3429) | |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2020-06-02 |