| NPI | 1619407855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 281539) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 271103) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2020-07-22 |