| NPI | 1801873633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 21372) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 35930) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2023-03-07 |