| NPI | 1992069348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AL 35961) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.061124) |
| Enumeration Date | 2012-06-30 |
| Last Update Date | 2018-06-11 |