| NPI | 1568627594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD162161) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D74059) |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2017-02-01 |