| NPI | 1689883993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 77572) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 48094) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2025-06-30 |