| NPI | 1467678557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 26827) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO CDR.0005002) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2025-05-19 |