| NPI | 1801045513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA 9622696) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 9622696) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NM MD2016-0322) | |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2022-07-15 |