| NPI | 1568669661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2017-00725) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD433263) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2022-01-13 |