| NPI | 1548265127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 40805) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA MD-44523) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 29342) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2020-09-02 |