| NPI | 1629020011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TX M4372) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: AR E-4612) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-07-22 |