| NPI | 1790806248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MO 2010014123) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MI 5101015350) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2017-03-14 |