| NPI | 1780905729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: IA DO-04375) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: WI 62049-21) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2023-12-20 |