| NPI | 1861871212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 332551) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 21563) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2022-08-22 |