| NPI | 1619147915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 42491) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 247585) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A129186) | |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2016-06-10 |