| NPI | 1215958459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: WI 55751) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MO 2006017171) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: LA MD.203593) | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2022-09-21 |