| NPI | 1760640429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101256322) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT188722) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2022-01-26 |