| NPI | 1144753062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2026008252) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 227887) |
| 207R00000X Internal Medicine (Licence: IL 036152762) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036152762) | |
| 208M00000X Hospitalist (Licence: IL 036152762) | |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2026-05-26 |