| NPI | 1023462934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 153351) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA 153351) |
| Enumeration Date | 2016-04-17 |
| Last Update Date | 2026-08-24 |