| NPI | 1962476143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0066828) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD33179) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2019-06-06 |