| NPI | 1790095040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 63158) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A113689) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A113689) | |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2021-04-19 |