| NPI | 1164829636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2018030004) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2023-00874) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2023-00874) | |
| Enumeration Date | 2014-11-29 |
| Last Update Date | 2024-07-11 |