| NPI | 1669576757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 39991) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: HI MD-23100) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2025-05-01 |