| NPI | 1669887519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 326933) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 30685) |
| 207R00000X Internal Medicine (Licence: LA 326933) | |
| Enumeration Date | 2014-06-29 |
| Last Update Date | 2023-04-17 |