| NPI | 1780624023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME MD23009) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 09565) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.143494) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 9565) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2021-11-04 |