| NPI | 1073049748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101281722) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 28134) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2024-08-23 |