| NPI | 1578591160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CO 41837) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NM MD2024-0107) |
| 208C00000X Colon & Rectal Surgery (Licence: CO DR.0041837) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2024-03-05 |