| NPI | 1619952405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301051147) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301051147) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A52987) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2025-01-21 |