| NPI | 1306460910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME180230) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL MD.46568) |
| 207R00000X Internal Medicine (Licence: SC LL84240) | |
| Enumeration Date | 2020-05-31 |
| Last Update Date | 2026-06-01 |