| NPI | 1154524551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0068453) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 29301) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2022-08-11 |