| NPI | 1972554731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME0037518) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: WI 101902) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2024-08-26 |