| NPI | 1770998577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 89106) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301105644) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2021-06-30 |