| NPI | 1962630962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME126099) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 46150) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX Q6992) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2022-07-21 |