| NPI | 1699979187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD.206875) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD0000044191) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TN MD44191) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2017-04-10 |