| NPI | 1649274135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MI 5101017580) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MA 156841) |
| 207R00000X Internal Medicine (Licence: MI 5101017580) | |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2024-01-09 |