| NPI | 1528473964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 85361) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 259652) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2020-05-14 |