| NPI | 1770525826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: UT 9654364-1204) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: ME 1731) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2020-01-23 |