| NPI | 1881698264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 24155) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 24155) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2020-11-03 |