| NPI | 1588822878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0056020) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0056020) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD440748) | |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2025-07-23 |