| NPI | 1003895590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 35742) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 24999) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IA MD-31755) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 36565) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2020-08-18 |