| NPI | 1184854663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NM MD2019-0257) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2012019224) |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2026-07-23 |