| NPI | 1154307478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD28478) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA 61660628) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2026-06-16 |