| NPI | 1770877037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 2015-00344) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 248178) |
| Enumeration Date | 2011-06-04 |
| Last Update Date | 2018-03-29 |