| NPI | 1942644893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: AZ 49553) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MN 65712) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2020-09-09 |