| NPI | 1679147623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101027695) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5151014992) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 5101027695) | |
| Enumeration Date | 2021-05-14 |
| Last Update Date | 2024-11-20 |