| NPI | 1255599692 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 100358)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301092258)  | 
| Enumeration Date | 2008-05-31 | 
| Last Update Date | 2024-09-27 |