| NPI | 1528122595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 46246) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 231927) |
| 207R00000X Internal Medicine (Licence: PA MT183793) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2022-03-26 |