| NPI | 1669783510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME153007) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 245438) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A142014) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 57026) | |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2022-01-11 |