| NPI | 1811491053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AL 49922) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.151691) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2024-12-02 |