| NPI | 1548757834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0102205934) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102205934) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2024-06-27 |