| NPI | 1992700702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 17094) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 216277) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2020-05-28 |