| NPI | 1699773564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME157741) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.063641) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01055298A) | |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2022-09-02 |