| NPI | 1063497642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 14320) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 18210) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2025-03-04 |