| NPI | 1558587998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 252551) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP00455) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD.202069) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2019-12-18 |