| NPI | 1639460686 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 55350) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 55350) | 
| Enumeration Date | 2011-04-26 | 
| Last Update Date | 2020-07-01 |