| NPI | 1083061808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: GA 92309) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME134605) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: OK 34875) | |
| Enumeration Date | 2016-05-22 |
| Last Update Date | 2024-01-12 |