| NPI | 1053331421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD.13610R) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 105530) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 22745) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2025-08-21 |