| NPI | 1043703507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO TL.0009003) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.072150) |
| Enumeration Date | 2018-06-10 |
| Last Update Date | 2021-08-16 |