| NPI | 1356848501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0074435) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR DO218700) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2025-02-25 |