| NPI | 1649791542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX BP10069838) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125071387) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2022-05-26 |