| NPI | 1629518279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL OS19514) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL UO6957) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2023-06-22 |