| NPI | 1083391429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL TRN42652) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA ML61329457) |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2025-06-14 |