| NPI | 1124091392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VT 042.0015110) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101238587) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD453883) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0052832) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0077176) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2025-08-15 |