| NPI | 1780603555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: GA 61783) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: WI 31123) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2023-08-17 |