| NPI | 1104386770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA 19419) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 19419) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2026-01-19 |