| NPI | 1669499000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 21104) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX l7392) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IA MD-44761) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2021-08-18 |