| NPI | 1710946082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 61455) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 32268) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 230656) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2024-01-19 |