| NPI | 1518953025 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME154298) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 33833) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036088439) | |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2025-02-14 |