| NPI | 1699747055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR 162048) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI 11916) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2021-04-28 |