| NPI | 1649430216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101258115) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P1405) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35123165) | |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2018-08-20 |