| NPI | 1154702645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 29677) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 111662) |
| 208D00000X General Practice (Licence: NE 29677) | |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2026-03-24 |