| NPI | 1861413254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 200400682) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 84656) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2023-10-24 |