| NPI | 1699082149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME157450) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA 40880) |
| Enumeration Date | 2010-09-03 |
| Last Update Date | 2022-08-22 |