| NPI | 1710543772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OK 7576) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL82167) |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2022-06-23 |