| NPI | 1982130092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301509645) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 64429) |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2024-09-11 |