| NPI | 1912989781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: GA 100754) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: AK 4314) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2025-04-16 |