| NPI | 1255319877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NM MD2015-0843) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: AZ 49164) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: CO 34642) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2023-06-27 |