| NPI | 1700179983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: GA 077096) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301098214) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2020-08-03 |