| NPI | 1174055958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301509454) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A169880) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2023-08-18 |