| NPI | 1568881472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 57133) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R3986) |
| 207R00000X Internal Medicine (Licence: AZ 57133) | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2021-08-16 |