| NPI | 1487696043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 39652) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WY 7378A) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2021-06-09 |