| NPI | 1104876440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: GA 022254) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: GA 022254) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2024-02-01 |