| NPI | 1861528457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MT MED-PHYS-LIC-58486) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: WY 7943A) |
| 207R00000X Internal Medicine (Licence: MA 220124) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2025-04-10 |