| NPI | 1316207236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI L2226995) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA 20A15824) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2025-11-20 |