| NPI | 1558572743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0054591) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301085597) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2010025673) | |
| Enumeration Date | 2007-05-27 |
| Last Update Date | 2019-11-20 |