| NPI | 1013209592 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 92030)  | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD461143)  | 
| Enumeration Date | 2011-05-03 | 
| Last Update Date | 2024-07-10 |