| NPI | 1194757823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 30774) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MT 103660) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2023-08-16 |