| NPI | 1629398979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 075026) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 245253) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL 18508) | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2018-02-05 |