| NPI | 1982646519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101234966) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC TL25505) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME114318) | |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2018-10-31 |