| NPI | 1659325165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME0109365) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 36550) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-01-17 |