| NPI | 1568841161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 3624) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO3824) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2022-04-25 |