| NPI | 1801289764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101261668) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NV 22053) |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2024-07-03 |