| NPI | 1972816171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME131840) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 56699) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2021-01-12 |