| NPI | 1194802074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 77338) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 19129) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2023-10-24 |