| NPI | 1649384751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA C50233) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 21151) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: ME MD23620) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2021-09-22 |