| NPI | 1780034074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0062374) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2016019264) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2022-07-27 |