| NPI | 1265412019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA 21426) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO CDR.0003619) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MT 44672) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD219052) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2025-04-28 |