| NPI | 1306848965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2024-02434) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 99812) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME85567) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2025-04-07 |