| NPI | 1841304458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 066319) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC TL26199) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: GA 066319) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2020-10-07 |