| NPI | 1114999570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 70565) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 37410) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA C131598) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2024-10-20 |