| NPI | 1497117519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL TRN19443) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 123456) |
| 207R00000X Internal Medicine (Licence: FL TRN19443) | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2022-05-17 |