| NPI | 1861920969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NM MD2021-0485) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 271884) |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2022-07-21 |