| NPI | 1194962803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA 136450) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301092558) |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2025-06-30 |