| NPI | 1649277666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 29401) |
| Additional Taxonomies | 174400000X Specialist |
| 174400000X Specialist (Licence: AZ 29600) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2022-11-28 |