| NPI | 1710247986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101275567) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AL 19388) |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2022-11-18 |