| NPI | 1700016185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME MD22822) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 241023) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 251153) | |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2019-07-18 |