| NPI | 1790968816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NV 13226) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A87256) |
| 207R00000X Internal Medicine (Licence: NV 13226) | |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2017-02-21 |