| NPI | 1912263427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 201802617) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101258292) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2023-11-27 |