| NPI | 1306820139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101034268) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301512718) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2025-09-08 |