| NPI | 1346700390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2024-03447) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.073764) |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2025-03-20 |