| NPI | 1699748988 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 052771) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 052771) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2018-08-16 |