| NPI | 1255322475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NH 25444) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 50683) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: MA 50683) | |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2024-02-20 |