| NPI | 1932786712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 83854) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 31669) |
| 207R00000X Internal Medicine (Licence: WI 72066) | |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2024-06-10 |