| NPI | 1760877310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 91012) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 63255) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 63726) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2022-00132) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 63255) | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2023-07-28 |