| NPI | 1083176028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 99352) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2022-00905) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2026-08-18 |