| NPI | 1831170612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CO DR.0070209) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: SC 19975) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2024-05-06 |