| NPI | 1548615339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: AZ 66642) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R75484) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: MO 2019022799) | |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2022-09-06 |