| NPI | 1790112191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME117374) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101253084) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036091094) | |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2022-03-21 |