| NPI | 1255697868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0065947) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AL 38294) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 79312) | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2021-06-01 |