| NPI | 1710252861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 266268) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 54035) |
| 207R00000X Internal Medicine (Licence: MA 266268) | |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2019-09-19 |