| NPI | 1134137011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME179089) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2002001059) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 74648) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2026-04-24 |