| NPI | 1770873465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 85883) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NM MD2015-0914) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD194315) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CO Dr.0070810) | |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2024-08-16 |