| NPI | 1558629857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101270872) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 281420) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2022-06-09 |