| NPI | 1811276553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 078477) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301099097) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2021-07-15 |