| NPI | 1912914102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2013-00007) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 101234858) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2023-10-24 |