| NPI | 1174509491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0102204930) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI dos-1001) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2022-07-21 |