| NPI | 1780668061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA 05004597L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA 05004597L) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2020-02-19 |