| NPI | 1518016187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101246147) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101246147) |
| 208D00000X General Practice (Licence: CA A92523) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-09-10 |