| NPI | 1922455864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A173226) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX S7429) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2022-08-28 |