| NPI | 1245215292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301075803) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2011009900) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 27828) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2024-03-14 |