| NPI | 1811907306 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR CP204575) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME65674) | 
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 76094) | |
| Enumeration Date | 2006-08-08 | 
| Last Update Date | 2024-09-10 |