| NPI | 1982648259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2000156761) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 55536) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2019-07-22 |