| NPI | 1043266349 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0065775)  | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 202358)  | 
| Enumeration Date | 2006-05-26 | 
| Last Update Date | 2021-09-30 |