| NPI | 1053373316 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 019003)  | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 12295)  | 
| Enumeration Date | 2006-04-03 | 
| Last Update Date | 2023-12-11 |