| NPI | 1154760155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 85948) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX S7625) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A150020) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX S7625) | |
| Enumeration Date | 2013-06-23 |
| Last Update Date | 2026-09-04 |