| NPI | 1801877683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 46539) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NM 99-94) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2021-06-03 |