| NPI | 1528419066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA DO-06040) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO TL.0006064) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0059275) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2022-07-13 |