| NPI | 1306822069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME MD30810) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 78918) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2026-07-30 |