| NPI | 1720015225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 50802) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 30402-020) |
| 207R00000X Internal Medicine (Licence: IL 036115630) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2020-10-25 |