| NPI | 1881157287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: UT 12875327-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R77246) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2023-03-03 |