| NPI | 1043662463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 92138) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 96038) |
| Enumeration Date | 2016-07-09 |
| Last Update Date | 2026-06-15 |