| NPI | 1922072560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MT 26717) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101233776) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2021-08-05 |