| NPI | 1780650440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL 145951) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101236679) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2022-05-19 |