| NPI | 1598787491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: PR 16768) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 2003-00666) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2023-03-07 |