| NPI | 1932530680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: WI 18373-875) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: FL OS13957) |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2022-05-13 |