| NPI | 1689938938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL TRN21544) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 253082) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2019-01-18 |