| NPI | 1275083263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 102043) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD469367) |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2025-08-05 |