| NPI | 1952393209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 90282) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME0060078) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CO CDR.0001985) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 71344) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2024-05-31 |