| NPI | 1821094301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 13033) |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 13033) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2020-05-07 |