| NPI | 1760822191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A152257) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2022-1351) |
| 207R00000X Internal Medicine (Licence: MS 888-L) | |
| Enumeration Date | 2013-06-29 |
| Last Update Date | 2024-04-24 |