| NPI | 1962828772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 1340) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 1340) |
| 208D00000X General Practice (Licence: NE 1340) | |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2023-08-14 |