| NPI | 1174964019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 2025-00842) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: IA MD-46841) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2025-07-17 |