| NPI | 1679636120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 65634) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 0062775) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME133167) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 63645) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01063094A) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-03-06 |