| NPI | 1568897668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 84807) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 390200000X -) |
| Enumeration Date | 2013-09-08 |
| Last Update Date | 2020-06-01 |