| NPI | 1699112086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 49426) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 10226566-1205) |
| Enumeration Date | 2013-05-27 |
| Last Update Date | 2021-12-17 |