| NPI | 1053831008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 2024-01374) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2024-01374) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2024-06-18 |