| NPI | 1619063450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2007-00355) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH RT 1366) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2023-01-30 |