| NPI | 1255017810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 3015379) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 3015379) |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2024-01-03 |