| NPI | 1073932398 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MT MED-PHYS-LIC-143554)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A141119)  | 
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A141119)  | |
| Enumeration Date | 2014-04-15 | 
| Last Update Date | 2024-11-25 |