| NPI | 1609804228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT 7074) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MT 7074) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2017-01-11 |