| NPI | 1932112653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 325768) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 325768) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 045739) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2023-08-21 |