| NPI | 1558770743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 33345) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 7174) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 32530) | |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2024-02-14 |