| NPI | 1891156824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI 390200000) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0102207990) |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2023-08-15 |