| NPI | 1336435965 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 54218) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35134037) | 
| 207R00000X Internal Medicine (Licence: CT 54218) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: DE C1-0012777) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D83058) | |
| Enumeration Date | 2011-06-22 | 
| Last Update Date | 2025-08-05 |