| NPI | 1467486969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MI 4301069585) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301069585) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: ND 8745) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-09-10 |