| NPI | 1669606109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME133140) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 18180) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: DC MD043743) | |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2020-10-14 |