| NPI | 1679008692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 75262) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.070288) |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2024-08-05 |