| NPI | 1144292459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 200400474) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD36833) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2026-05-15 |