| NPI | 1548245806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: DE C1-0012813) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NC 9600169) |
| 174400000X Specialist (Licence: NC 151718) | |
| 207R00000X Internal Medicine (Licence: VA 0101048956) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101048956) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2023-01-11 |