| NPI | 1760702302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME118005) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10036738) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: WI 67698) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: MI 4301104486) | |
| Enumeration Date | 2010-06-06 |
| Last Update Date | 2023-04-04 |