| NPI | 1619941127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 21364) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD423626) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2018-10-29 |