| NPI | 1962472589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 38289-20) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI JK079482) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2021-12-10 |