| NPI | 1942533997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME135893) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC LL32063) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX P7060) | |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2018-07-11 |