| NPI | 1639434368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 58548) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 49037) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2022-02-11 |