| NPI | 1972824787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 2016-00551) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL32658) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2016-06-27 |