| NPI | 1912984972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME105582) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2000165890) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2024-04-17 |