| NPI | 1972768505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301098249) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 52071) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2023-09-29 |