| NPI | 1780099218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 76771) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 83043) |
| 207R00000X Internal Medicine (Licence: GA 7001) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2024-04-01 |