| NPI | 1760659866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CA A110174) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A110174) |
| 207R00000X Internal Medicine (Licence: MI 4301097844) | |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2022-01-25 |