| NPI | 1861627697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 51592) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 53079-020) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME163699) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 53079) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: ME MD22357) | |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2024-04-02 |