| 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 |