| NPI | 1831489616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: GA 80740) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036142470) |
| 207R00000X Internal Medicine (Licence: MI 4301104643) | |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2018-06-27 |