| NPI | 1558344267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 17831) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 32150) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 0054299) | |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2023-01-20 |