| NPI | 1144752106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD048197) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0098776) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 71523) | |
| 207R00000X Internal Medicine (Licence: TN 71523) | |
| 207R00000X Internal Medicine (Licence: DC MD048197) | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2025-09-29 |