| NPI | 1598804346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CA A54545) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MT 117660) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2023-06-09 |