| NPI | 1548260250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2010-01557) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 2010-01557) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2024-07-15 |