| NPI | 1487966727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A140340) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT197564) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2021-11-29 |