| NPI | 1215340674 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME174469) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A154629) | 
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A154629) | |
| Enumeration Date | 2014-06-03 | 
| Last Update Date | 2025-08-18 |