| NPI | 1114162625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 33798) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301093433) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301093433) | |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2025-03-02 |