| NPI | 1659370930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: SD 8918) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NH 11539) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: WI 33276) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2019-05-14 |