| NPI | 1699125559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV Fl1153) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL OS18475) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2022-08-19 |