| NPI | 1306285739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A168382) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 297953) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2025-12-18 |