| NPI | 1790786002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G646260) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G64626) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2020-12-29 |