| NPI | 1487911376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301106627) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 18755) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2023-04-26 |