| NPI | 1962452367 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: SC 18042) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101282315) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101282315) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2024-12-27 |