| NPI | 1962461004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 342098) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME88335) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME88335) | |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2024-09-04 |