| NPI | 1427035328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 15932) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 34881) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2020-09-03 |