| NPI | 1043607203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 209945) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 209945) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2025-09-07 |