| NPI | 1972733616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 45468) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 51178) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2016-08-24 |