| NPI | 1710108345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101256562) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0076005) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD042535) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2021-03-22 |