| NPI | 1912009192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 0059805) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AR E-7620) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2019-01-28 |