| NPI | 1174151054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0105990) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 284660) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2026-05-04 |