| NPI | 1508279332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 36961) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL36961) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2021-05-27 |