| NPI | 1982040358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 94618) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 67567-20) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2023-02-28 |