| NPI | 1568721900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60838593) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.022093) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01075305A) | |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2018-08-06 |