| NPI | 1518410091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 31802) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA MD45497) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2023021293) | |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2023-09-07 |