| NPI | 1205490166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2025-01705) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 1014279) |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2025-09-22 |