| NPI | 1992790463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 20233) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD.025422) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2020-07-22 |