| NPI | 1164800173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0066149) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301117185) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2026-03-04 |