| NPI | 1780905588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 02003971A) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 207R00000X Internal Medicine (Licence: IN FA3089225) | |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2024-05-24 |