| NPI | 1700998150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 24037) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 24037) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: ND 9060) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-02-27 |