| NPI | 1902819667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: GA 68180) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD429444) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: MA 247627) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2024-08-15 |