| NPI | 1619991148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 93541) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD192944) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD.10541R) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME0058947) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-02-20 |