| NPI | 1811482748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 202401335) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2018022274) |
| Enumeration Date | 2018-06-23 |
| Last Update Date | 2024-07-17 |