| NPI | 1194080945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2015009547) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MO 2015009547) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2026-07-01 |