| NPI | 1790917870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2018-00554) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 270637) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01079615A) | |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2018-06-22 |