| NPI | 1639156300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME42810) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 29786) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2022-12-15 |