| NPI | 1659669273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 003724) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101019440) |
| Enumeration Date | 2011-07-17 |
| Last Update Date | 2019-10-03 |