| NPI | 1831171461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 37883) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MDR-4640) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: GA 69272) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: SC 37883) | |
| 208D00000X General Practice (Licence: GA 69272) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2024-03-22 |